Healthcare Provider Details

I. General information

NPI: 1912220005
Provider Name (Legal Business Name): CHERYL LYNN HARB R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1142 WEHRLE DR
WILLIAMSVILLE NY
14221-7748
US

IV. Provider business mailing address

41 PRESIDIO PL
WILLIAMSVILLE NY
14221-3723
US

V. Phone/Fax

Practice location:
  • Phone: 716-631-3381
  • Fax: 716-631-3097
Mailing address:
  • Phone: 716-626-1119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number035128
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: